Marketing ‘Obamacare’ big challenge

CHICAGO -- It will make you stronger. It will give you peace of mind and make you feel like a winner. Health insurance is what the whole country has been talking about, so don't be left out.

Sound like a sales pitch? Get ready for a lot more. As President Barack Obama's health care law moves from theory to reality in the coming months, its success may hinge on whether the best minds in advertising can reach one of the hardest-to-find parts of the population: people without health coverage.

The campaign won't come cheap: The total amount to be spent nationally on publicity, marketing and advertising will be at least $684 million, according to data compiled The Associated Press from federal and state sources.

About 16 percent of Americans are uninsured, but despite years of political debate and media attention, more than three-quarters of them still know little about the law known as "Obamacare," according to recent surveys.

"It's not sugar cereal, beer and detergent," said Brooke Foley, chief executive officer of the Chicago-based Jayne Agency, one of the advertising firms crafting messages to reach the uninsured.

The Obama administration and many states are launching campaigns this summer to get the word out before enrollment for new benefits begins in October.

The targets are mostly the working poor, young people who are disengaged, or those who gave up their insurance because of the cost. Three-quarters are white. Eighty-six percent have a high school education or less. Together they make up a blind spot in the nation's health care system.

"They've been shut out. It's too expensive and it's incredibly confusing," said David Smith of the advertising agency GMMB, pitching the health law's benefits in Washington and Vermont.

Their confusion might only have been magnified by the administration's surprise announcement recently postponing part of the system that affects businesses. But that change should not affect many individuals. A bigger complication is that in about half the states, Republican governors are declining to cooperate, which will limit the marketing.

The states that have been more receptive to the health care overhaul and are further ahead in their planning will receive proportionally more federal money for outreach, advertising and marketing than Republican-led states that have been hostile to the law.

AP research from all 50 states shows the amount of government spending will range from a low of 46 cents per capita in Wisconsin, which has ceded responsibility for its health insurance exchange to the federal government, to $9.23 per capita in West Virginia, which opted for a state-federal partnership.

About $4.8 million in public money will be spent trying to sign up New Jersey's 1.3 million uninsured, for example, compared to the nearly $28 million spent reaching out to Washington state's much smaller 960,000.

Texas has the highest percentage of uninsured people in the nation, three times more than Illinois. But only a fourth as much public money will be spent on getting people enrolled in Texas.

Austin resident Caryl Mauk, 46, remains confused about the Affordable Care Act even though Texas' federally run exchange is just two months away from opening for enrollment.

She hasn't had insurance since she had to quit her nursing job in 2011 because of a heart condition. She's been struggling with chest pains, arthritis and fatigue but doesn't know what to make of the new program.

"Sometimes I just get overwhelmed," Mauk said. "I don't want to get bad news again, and that slows me down in making calls."

In the GOP states, community groups with federal grants will lead the effort.

Ads based on research about the uninsured will soon start popping up on radio, TV and social media. Grassroots organizers are recruiting their pastors, barbers and mothers and arming them with carefully worded messages. In some neighborhoods, volunteers will go door-to-door.

The pitch: If you don't make much money, the government can pick up some of the cost of your health insurance. If you can afford a policy, by law you have to get one. By getting more people insured, the government hopes they'll get health care earlier, before winding up in emergency rooms with expensive problems that could have been prevented.

The political stakes for the Obama administration in a big response are high. If only the sickest people sign up, the cost of their medical care could overburden insurance carriers and sink the new marketplaces. The new system depends on a balanced pool.

The ad campaign already underway in Colorado demonstrates the search for an effective message.

There, TV commercials show people being magically transformed into champions. One minute they're shopping for health insurance on a computer, the next they're winning at a horse race, in a casino or at the World Series with champagne corks flying. The slogan: "When health insurance companies compete, the only winner is you."

That's because market research shows Coloradans like competition, said Tom Leydon, CEO of Denver-based advertising and digital marketing agency Pilgrim.

The celebratory scenes "remind people of the good feeling they get when they win," he said.

Despite the focus on winning and champions, there may be little if any cooperation for the publicity blitz from the professional sports leagues, which would have the potential to reach tens of millions of people. Two Republican Senate leaders warned the leagues about getting involved in "a highly polarized public debate."

In states where there will be no official cooperation, Enroll America, a coalition of health companies and advocates, has deployed volunteers to hand out brochures at a farmers market in Austin and hold house parties in Cincinnati, and plans a seven-figure ad buy across the nation.

"There has to be an echo chamber," said John Gilbert, national field director for the Enroll America media campaign. "If I'm uninsured and it's October, I won't be able to go anywhere without (hearing) the message of enrollment."

"The bottom line is the dollar sign," said Upshaw, 27, who survived a shooting three years ago. "I would love to be able to go in and see a doctor and make sure I'm OK."

In Chicago, the Jayne Agency's staff talked to more than 50 patients at an emergency room to hone the best message. The slogan they chose: "Don't Just Get By." The ad campaign features real people and their health stories.

On a recent Sunday in southwest Houston, volunteers recruited by Blue Cross Blue Shield set up information tables at a community center where three Methodist church services are held.

"I'm looking to get where I can go to the doctor and have a $25 to $30 co-pay," said churchgoer Yolanda Boykin, 60, whose current job through a temp agency does not provide health insurance.

Another part of the campaign nationwide, focused on young men, is refining messages for their mothers.

Market research has shown that young adults say it's often a parent, a girlfriend or a sibling who will push them to sign up for something like health insurance, said Julie Bataille, helping lead the outreach for the Obama administration, so the campaign will "make sure moms are aware."